Assessment of Left Atrial Global Longitudinal Strain in Patients With Cerebrovascular Ischemic Accidents and No Evidence of Atrial Fibrillation

Cardioembolic strokes cause more severe disabilities than other subtypes of ischemic strokes. Considering that thrombus formation predominantly occurs in the left atrium (LA), the structure and function of the LA may cause a risk for embolic strokes even in the absence of atrial fibrillation (AF). We hypothesized that functional and structural LA alterations could be associated with acute ischemic strokes regardless of AF occurrence and history.

This comparative cross-sectional study assessed 40 patients with cerebrovascular accidents (CVA) and 40 healthy controls. We included patients aged above 18 years with ischemic CVA within the preceding 6 months and without AF rhythm. Global longitudinal strain (GLS) was calculated using 2D speckle-tracking echocardiography.

Significant differences existed between the 2 groups regarding the mean values of LAA4C GLS (P=0.01), LAA3C GLS (P=0.002), LAA2C GLS (P=0.002), LA TOTAL GLS (P=0.001), LVA4C GLS (P=0.01), and LV TOTAL GLS (P=0.04). Nevertheless, no significant differences existed in the LA area, LA diameter, EF, LVEDV, LVESV, LVA3C GLS, and LVA2C GLS between the groups.

Our findings suggested the possible involvement of LA morphofunctional dysfunction in CVA events in patients with sinus rhythm.